儿童不同标本来源分离的大肠埃希菌耐药性分析

朱海蛟, 饶冠利, 张德忠

中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (05) : 348-350.

PDF(1008 KB)
PDF(1008 KB)
中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (05) : 348-350.
论著·临床研究

儿童不同标本来源分离的大肠埃希菌耐药性分析

  • 朱海蛟,饶冠利,张德忠
作者信息 +

Antimicrobial resistance of Escherichia coli isolated from different samples in children

  • ZHU Hai-Jiao, RAO Guan-Li, ZHANG De-Zhong
Author information +
文章历史 +

摘要

目的:对儿童不同标本进行大肠埃希菌分离培养,了解不同标本大肠埃希菌分离株的耐药率差异,以便指导临床合理使用抗菌药物。方法:收集629份2004年6月至2009 年5月儿童尿液、痰液、血液、分泌物等标本,采用VITEK-32全自动微生物鉴定药敏仪进行细菌鉴定,药敏测定采用K-B法,并比较不同标本所检出大肠埃希菌对抗菌药物的耐药率差异。结果:共检出大肠埃希菌260株,其中尿108 株,痰64株,分泌物54株,血液23株。大肠埃希菌株ESBLs、AmpC、同产ESBLs+AmpC检出率分别为36.9%、12.3%和3.1%,其中痰液大肠埃希菌分离株ESBLs检出率明显高于其他标本(P<0.05),不同标本的大肠埃希菌分离株对阿莫西林/克拉维酸、替卡西林/克拉维酸、哌拉西林、头孢噻肟、头孢呋辛、头孢吡肟、庆大霉素、复方新诺明、呋喃妥因的耐药率不同,其中痰液分离株的耐药率明显高于其他标本(P<0.05)。结论:儿童不同标本分离的大肠埃希菌对多种抗菌药物耐药率不同,建议临床医师在治疗不同标本来源分离培养的大肠埃希菌引起的感染时,应根据药敏结果合理使用抗菌药物。[中国当代儿科杂志,2010,12(5):348-350]

Abstract

OBJECTIVE: To investigate the possible differences in antimicrobial resistance of Escherichia coli isolated from different samples in children. METHODS: Six hundred and twenty-nine samples from urine, sputum, blood and secretion were collected from June 2004 to May 2009 for bacterial identification by VITEK-32 automatic system and antimicrobial susceptibility tests by Kirby-Bauer method. The drug resistance rate of Escherichia coli isolated from different samples was compared. RESULTS: Two hundred and sixty strains of Escherichia coli were isolated , and 108 of which were from urine , 64 from sputum, 54 from secretion and 23 from blood. ESBLs were detected in 96 (36.9%) of the 260 isolates, AmpC enzymes in 32 (12.3%), and ESBLs+AmpC in 8 (3.1%). The ESBLs positive rate of Escherichia coli isolates from sputum was significantly higher than that from other samples (P<0.05). The antimicrobial resistance rate of Escherichia coli strains from different samples to amoxicillin/clavulanic acid, ticarcillin/clavulanic acid, piperacillin, cefotaxime, cefuroxime, cefepime, gentamicin, cotrimoxazole, and nitrofurantoin was different. The resistance rate of the strains from sputum samples was higher than that from the other samples(P<0.05). CONCLUSIONS: Escherichia coli isolated from different samples have different antimicrobial resistance rates in children, so the selection of antibiotics for infections confirmed by bacterial cultures from different samples should based on drug sensitivity results. [Chin J Contemp Pediatr, 2010, 12 (5):348-350]

关键词

大肠埃希菌 / 抗菌药物 / 耐药性 / 儿童

Key words

Escherichia coli / Antimicrobial agent / Drug resistance / Child

引用本文

导出引用
朱海蛟, 饶冠利, 张德忠. 儿童不同标本来源分离的大肠埃希菌耐药性分析[J]. 中国当代儿科杂志. 2010, 12(05): 348-350
ZHU Hai-Jiao, RAO Guan-Li, ZHANG De-Zhong. Antimicrobial resistance of Escherichia coli isolated from different samples in children[J]. Chinese Journal of Contemporary Pediatrics. 2010, 12(05): 348-350
中图分类号: R969   

参考文献

[1]黄长武,梅雪芬,李兴绿. 大肠埃希菌AmpC酶及ESBLs检测与耐药性分析[J]. 中国抗生素杂志,2005,30(11):686-688.
[2]吴伟元,陈民钧,王辉. 阴沟肠杆菌去阻遏持续高产AmpC 酶和超广谱β-内酰胺酶的检测[J]. 中国临床药理学杂志,2001,17(2):104-109
[3]方平,潘晓龙,周东升,吴同生,吴祥林. 医院感染与社区获得性感染革兰阴性杆菌耐药性与β-内酰胺酶的分布对比[J].中华医院感染学杂志,2006,16(3):335-339.
[4]Clinical and Laboratory Standard Insititue. Performance standards for antimicrobial susceptibility testing: fourteenth information supplement[S]. 2004: 1-150.
[5]罗燕萍, 张秀菊, 徐雅萍, 田芳, 沈定霞. 产超广谱β-内酰胺酶肺炎克雷伯氏菌和大肠埃希氏菌的分布及其耐药性研究[J]. 中华医院感染学杂志, 2006, 16(1):101-104.
[6]蔡志军,马志远,邓玉丽.产超广谱β-内酰胺酶大肠埃希氏菌耐药谱分析[J].现代诊断与治疗, 2006,17(1):13-15.
[7]唐朝贵,郑绍同,孙海平,韩其香,傅启云. 社区及医院感染大肠埃希菌产AmpC 酶、ESBLs 检测与耐药性分析[J]. 中国感染控制杂志,2007, 6(4):255-258.
[8]滕琳, 苏芬, 甄永强,吴立平,王乐强. 产超广谱β-内酰胺酶细菌肺部感染及耐药性分析[J].中华医院感染学杂志, 2002, 12(12):948-949.


PDF(1008 KB)

Accesses

Citation

Detail

段落导航
相关文章

/